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Clinical scoring system suggests possibility of more precise colon cancer screening

A clinical scoring system for could help physicians identify which average-risk patients could potentially skip a colonoscopy and instead be screened with a less-invasive method. The researchers suggest that this approach could increase the uptake and efficiency of colorectal (CRC) screening. The cross-sectional study is published in Annals of Internal Medicine.

Several screening tests are proven effective and are recommended for detecting , yet screening is still underused, costly, and inefficient. Not all average-risk patients have the same risk for . Risk stratification could potentially enable physicians to tailor screening based on a patient’s risk for .

Researchers studied a convenience sample of 4,460 patients scheduled to undergo their first screening colonoscopy in the Midwest. A clinical score was given based on the patient’s complete health data and presence of the five most common for CRC – age, sex, waist circumference, cigarette smoking, and family history. The data showed that patients classified as low-risk did, in fact, have far fewer advanced adenomas compared with patients classified as high-risk. The authors suggest that patients at lower risk for cancer would be able to have a less invasive test (sigmoidoscopy, occult blood tests), while higher-risk patients would need a colonoscopy.

The author of an accompanying editorial cautions that the score should not be used for choosing the type of an average-risk person should have. However, a sensitive algorithm may have a role in choosing appropriate follow up for a patient with a negative screening result.